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End-of-life care

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https://www.readbyqxmd.com/read/29351142/worldwide-end-of-life-practice-for-patients-in-icus
#1
Wai-Tat Wong, Jason Phua, Gavin M Joynt
PURPOSE OF REVIEW: Published data and practice recommendations on end-of-life (EOL) generally reflect Western practice frameworks. Understanding worldwide practices is important because improving economic conditions are promoting rapid expansion of intensive care services in many previously disadvantaged regions, and increasing migration has promoted a new cultural diversity previously predominantly unicultural societies. This review explores current knowledge of similarities and differences in EOL practice between regions and possible causes and implications of these differences...
January 18, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29350577/serial-palliative-performance-scale-assessment-in-a-university-general-hospital-a-pilot-study
#2
Rafael Barone de Medeiros, Ana Maria Nunes de Faria Stamm, Rachel Duarte Moritz, Paulo Fontoura Freitas, Lara Patrícia Kretzer, Juliana Vieira Gomes
BACKGROUND: Serial Palliative Performance Scale (PPS) assessments may predict functional decline and prognosis in cancer and noncancer patients and help with end-of-life decision making. OBJECTIVE: To evaluate the functional status of using serial PPS assessments of patients being assisted in collaboration with the palliative care team (PCT). DESIGN: Prospective cohort pilot study. MEASUREMENTS: The sample consisted of 64 cancer and noncancer inpatients being assisted in collaboration with the PCT during the period from 2012 to 2016 (included 12 months)...
January 19, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29349518/checkpoint-inhibitors-palliative-care-or-hospice
#3
REVIEW
Mellar P Davis, Rajiv Panikkar
PURPOSE: Checkpoint (CTLA-4, PD-1, and PD-L1) inhibitors have changed the face of oncology. A subset of patients enjoys long, gratifying treatment responses. Unfortunately, most patients do not respond even when expressing favorably markers such as PD-L1. Checkpoint inhibitors are largely palliative (though a subset have long-term cancer responses) and as such patient-related outcome measures should be included when evaluating benefits. The purpose of this review is to place checkpoint inhibitor trials within a palliation context...
January 19, 2018: Current Oncology Reports
https://www.readbyqxmd.com/read/29349220/adult-mortality-in-sub-saharan-africa-zambia-where-do-adults-die
#4
Vesper H Chisumpa, Clifford O Odimegwu, Nicole De Wet
Place of death remains an issue of growing interest and debate among scholars as an indicator of quality of end-of-life care in developed countries. In sub-Saharan Africa, however, variations in place of death may suggest inequalities in access to and the utilization of health care services that should be addressed by public health interventions. Limited research exists on factors associated with place of death in sub-Saharan Africa. The study examines factors associated with the place of death among Zambian adults aged 15-59 years using the 2010-2012 sample vital registration with verbal autopsy survey (SAVVY) data, descriptive statistics and multivariate logistic regression analysis...
December 2017: SSM—Population Health
https://www.readbyqxmd.com/read/29348384/clinical-outcomes-of-geriatric-care-in-cipto-mangunkusumo-hospital-before-and-after-the-implementation-of-national-health-insurance-program
#5
Czeresna Heriawan Soejono, Retna S Padmawati, Adi Utarini
BACKGROUND: the National Health Insurance (NIH/JKN) has been enacted since January 2014. Various outcomes of geriatric patient care, such as improved functional status and quality of life have not been evaluated. Prolonged hospitalization and re-hospitalization are potentially affecting the efficiency care of this vulnarable group. This study aimed to identify the differences of functional status improvement, quality of life improvement, length of stay, and hospitalization of geriatric patients admitted to CMH between prior to and after NHI implementation...
October 2017: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/29346697/surviving-end-of-life-care
#6
Lisa Marie Mellor
No abstract text is available yet for this article.
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29346473/treatment-for-alcohol-dependence-in-primary-care-compared-to-outpatient-specialist-treatment-a-randomized-controlled-trial
#7
Sara Wallhed Finn, Anders Hammarberg, Sven Andreasson
Aim: To investigate if treatment for alcohol dependence in primary care is as effective as specialist addiction care. Method: Randomized controlled non-inferiority trial, between groups parallel design, not blinded. The non-inferiority limit was set to 50 grams of alcohol per week. About 288 adults fulfilling ICD-10 criteria for alcohol dependence were randomized to treatment in primary care (men n = 82, women n = 62) or specialist care (men n = 77, women n = 67)...
January 16, 2018: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/29345756/clinical-intentions-of-antibiotics-prescribed-upon-discharge-to-hospice-care
#8
Sarah A Servid, Brie N Noble, Erik K Fromme, Jon P Furuno
OBJECTIVES: To better understand the clinical intentions for antibiotic prescribing upon discharge from acute care to hospice care. DESIGN: Retrospective cohort study. SETTING: Five hundred forty-four-bed academic, acute-care, tertiary referral hospital in Portland, Oregon. PARTICIPANTS: Adults (≥18) who received an outpatient prescription for antibiotics on discharge from an acute care hospital to hospice care between January 1, 2009 and December 31, 2011 (N = 149)...
January 18, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29345092/-known-unknowns-examining-the-burden-of-neurocognitive-impairment-in-the-end-stage-renal-failure-population
#9
REVIEW
Scott Wilson, Arup Dhar, Peter Tregaskis, Gavin Lambert, David Barton, Rowan Walker
The burden of neurocognitive impairment (NCI) in patients receiving maintenance dialysis represents a spectrum of deficits across multiple cognitive domains which are associated with hospitalisation, reduced quality-of-life, mortality and forced decision-making around dialysis withdrawal. Point prevalence data suggests that dialysis patients manifest NCI at rates 3-5 fold higher than the general population with executive function the most commonly affected cognitive domain. The unique physiology of the renal failure state and maintenance dialysis appears to drive an excess of vascular dementia subtype compared to the general population where classical Alzheimer's disease predominates...
January 18, 2018: Nephrology
https://www.readbyqxmd.com/read/29343891/first-two-bilateral-hand-transplantations-in-india-part-3-rehabilitation-and-immediate-outcome
#10
Mohit Sharma, Subramania Iyer, P Kishore, Jimmy Mathew, Sundeep Vijayaraghavan, Ravi Sankaran, Arun N Nair, R Janarthanan, Abhijeet Wakure, Raghuveer Reddy, S M Chetan Mali, Visakh Varma, Ashish Chaudhari, Swapnil Dhake, Akshay Omkumar
Introduction: This report covers the strategies adopted for rehabilitation for the first and second dual hand transplants performed in India. Materials and Methods: The team, under a trained physiatrist, including physiotherapy and occupational therapy personnel, was involved in the management of both these patients. The management protocol was developed considering previous reports as well as our management strategies in the rehabilitation of the replanted hands...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29343291/trends-in-the-performance-of-quality-indicators-for-diabetes-care-in-the-community-and-in-diabetes-related-health-status-an-israeli-ecological-study
#11
Ronit Calderon-Margalit, Michal Cohen-Dadi, Dana Opas, Dena H Jaffe, Jacob Levine, Arie Ben-Yehuda, Ora Paltiel, Orly Manor
BACKGROUND: Israel is one of the few countries that have a national program for quality assessment of community healthcare. We aimed to evaluate whether improved performance in diabetes care was associated with improved health of diabetic patients on a national level. METHODS: We conducted a nationwide ecological study estimating improvements in diabetes-related quality indicators and health outcomes. We estimated both correlations between composite measures of diabetes-related quality indicators and selected outcomes, and assessed through a joinpoint analysis whether trends in selected outcomes changed 4 years after the inception of the national program...
January 17, 2018: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/29343195/caring-for-a-family-member-or-friend-with-dementia-at-the-end-of-life-a-scoping-review-and-implications-for-palliative-care-practice
#12
Timothy R Broady, Freya Saich, Tom Hinton
BACKGROUND: Although people with dementia receive substantial care from informal sources, there is limited research available that investigates how these carers experience end-of-life care. AIM: This review aimed to identify what is currently known about carers' experiences of providing end-of-life care to a family member or friend with dementia and draw implications for palliative care policy and service provision. DESIGN: A scoping literature review was conducted, first using a targeted key word search, followed by assessments of eligibility based on title and then abstract content...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29343173/effects-of-two-feedback-interventions-on-end-of-life-outcomes-in-nursing-home-residents-with-dementia-a-cluster-randomized-controlled-three-armed-trial
#13
Jannie A Boogaard, Henrica Cw de Vet, Mirjam C van Soest-Poortvliet, Johannes R Anema, Wilco P Achterberg, Jenny T van der Steen
BACKGROUND: Despite increased attention for palliative care in dementia, recent studies found burdensome symptoms and unmet family caregiver needs in the last phase of life. Feedback is being used to improve the quality of palliative care, but we do not know how effective it is. AIM: To assess the effect of two feedback strategies on perceived quality of end-of-life care and comfort in dying nursing home residents with dementia. METHODS: In a cluster-randomized controlled trial, the End-of-Life in Dementia-Satisfaction With Care and the End-of-Life in Dementia-Comfort Assessment in Dying scales were completed by bereaved family caregivers of residents with dementia of 18 Dutch nursing homes...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29343169/patients-and-carers-perspectives-of-palliative-care-in-general-practice-a-systematic-review-with-narrative-synthesis
#14
Emilie Green, Selena Knight, Merryn Gott, Stephen Barclay, Patrick White
BACKGROUND: General practitioners have overall responsibility for community care, including towards end of life. Current policy places generalists at the centre of palliative care provision. However, little is known about how patients and carers understand the general practitioner's role. AIMS: To explore patient and carer perspectives of (1) the role of the general practitioner in providing palliative care to adult patients and (2) the facilitators and barriers to the general practitioner's capacity to fulfil this perceived role...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29343167/a-cluster-randomised-feasibility-trial-of-clinically-assisted-hydration-in-cancer-patients-in-the-last-days-of-life
#15
Andrew N Davies, Melanie Waghorn, Katherine Webber, Sigurd Johnsen, Jeewaka Mendis, Julia Boyle
BACKGROUND: The provision of clinically assisted hydration at the end-of-life is one of the most contentious issues in medicine. AIM: The aim of this feasibility study was to answer the question 'can a definitive (adequately powered) study be done?' DESIGN: The study was a cluster randomised trial, with sites randomised on a one-to-one basis to intervention 'A' (regular mouth care and usual other care) or intervention 'B' (clinically assisted hydration, mouth care and usual other care)...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29343041/forgoing-life-sustaining-treatments-in-the-icu-to-withhold-or-to-withdraw-is-that-the-question
#16
Giuseppe R Gristina, Francesca Baroncelli, Marco Vergano
In the last decades, mortality from severe acute illnesses has considerably declined thanks to the advances in intensive care medicine. Meanwhile, critical care physicians realized that lifesustaining treatments (LST) may not be appropriate for every patient, and end-of-life care in the Intensive Care Unit (ICU) started to receive growing attention. Most deaths occurring in the ICU now follow a decision to forgo life-sustaining treatments (DFLST), which can be implemented either by withdrawing (WDLST) or withholding (WHLST) life-sustaining treatments...
January 17, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29341962/withdrawal-of-life-sustaining-therapy
#17
Barbara G Jericho
PURPOSE OF REVIEW: The aim of this review is to examine literature relating to the withdrawal of life-sustaining therapy (WLST). RECENT FINDINGS: Discussions regarding end-of-life issues in adults and children are not occurring comprehensively. Discussions relating to the WLST in the pediatric population varies by institution and may vary by race, age, health insurance, diagnosis, and severity of illness. Completing advance directives prior to placement of life-sustaining treatments is not consistent practice...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29341836/a-cohort-study-of-patient-reported-outcomes-and-healthcare-utilization-in-acute-myeloid-leukemia-patients-receiving-active-cancer-therapy-in-the-last-six-months-of-life
#18
Jared R Lowe, Yinxi Yu, Steven Wolf, Greg Samsa, Thomas W LeBlanc
BACKGROUND: Evidence about the unique palliative care needs of patients with acute myeloid leukemia (AML) is limited. Improving the care of these patients will require a better understanding of their unmet needs, including symptom burden at the end of life, and patterns of healthcare utilization. OBJECTIVE: To describe AML patients' experiences in the last six months of life regarding symptom burden, blood product utilization, and use of palliative care services...
January 17, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29341551/reflection-on-curative-treatment-versus-palliation-of-symptoms-in-end-of-life-care
#19
Teresa Bridget Dowling
The conflicting tasks of treating or managing disease and preparing patients and their families for the end of life are well documented in haematology and palliative care settings. This article is a reflection on practice by a nursing student who was in the fourth year of an internship, and discusses a case study involving a woman at the end of life. It considers the approach to palliative and end of life care adopted in an oncology and haematology ward where there was a reluctance to be realistic about the limitations of treatments among some healthcare practitioners, who did not want to dispel unrealistic expectations of the patient's recovery as a result of continuing treatment...
January 17, 2018: Nursing Standard
https://www.readbyqxmd.com/read/29341466/effects-of-intravenous-home-dobutamine-in-palliative-end-stage-heart-failure-on-quality-of-life-heart-failure-hospitalization-and-cost-expenditure
#20
Pieter Martens, Jan Vercammen, Wendy Ceyssens, Linda Jacobs, Evert Luwel, Herwig Van Aerde, Peter Potargent, Monique Renaers, Matthias Dupont, Wilfried Mullens
AIMS: In patients with palliative end-stage heart failure, interventions that could provide symptomatic relief and prevent hospital admissions are important. Ambulatory continuous intravenous inotropes have been advocated by guidelines for such a purpose. We sought to determine the effect of intravenous dobutamine on symptomatic status, hospital stay, mortality, and cost expenditure. METHODS AND RESULTS: All consecutive end-stage heart failure patients not amenable for advanced therapies and discharged with continuous intravenous home dobutamine from a single tertiary centre between April 2011 and January 2017 were retrospectively analysed...
January 17, 2018: ESC Heart Failure
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